Search results for black cohosh

It’s all in the spin

Posted by Liz on Jan 19, 2009 in herbal medicine | 2 comments

I’d like to believe that researchers have patients’ best interest at heart but an article in this month’s British Medical Journal’s Drug and Therapeutic Bulletin has led me to believe that objectivity can be difficult.

The piece, entitled “Herbal medicine for menopausal symptoms,” positions itself as a review of the effectiveness and safety of herbal medicines commonly used for relief of vasomotor symptoms, including hot flashes and night sweats.  The herbs covered within the piece include black cohosh, red clover, dong quai, evening primrose, ginseng, and briefly wild yam, chaste tree, hops, sage leaf and kava kava.

However, within the first two paragraphs, it becomes abundantly clear that the review is aimed at attacking the validity of so-called “alternative” therapies and consequently, attempts to provide the evidence that does so.

The author correctly points out that the consumer might automatically deem such products safe since they are natural, and that many products on the shelves do not comply with good manufacturing standards. In fact, I’ve written on these very essential considerations.

However,  s/he blatantly (and incorrectly) states that “there has been a lack of studies of herbal medicines for menopausal symptoms,” emphasizing in particular (but not defining) the following:  faults in study design, number of participants and length of study. The author also criticizes the use of traditional herbal systems (e.g., Traditional Chinese Medicine), which s/he says has little published research that supports its use in treatment of menopausal symptoms.

Although I did not review each study individually, I would like to point out that the author’s claim of a lack of published studies can be easily  disputed. Using the search term:

• “Herbal medicine for menopause,” I pulled 6 pages (104 studies) of scientifically-designed, herbal medicine trials on the National Institute of Medicine’s Pub med database
• With the term “black cohosh,” I pulled 20 pages or 431 studies
• With the term “red clover,” I found an additional 76 studies
• Ginseng and menopause – 20 studies
• Traditional Chinese medicine and menopause – 47 studies
• Dong Quai – 24 studies
• Evening Primrose – 25 studies

Notably, I did not search databases that specialize specifically in complementary therapies or more importantly, the Traditional Chinese Medicine database.

The gist of the data cited within the DTB Review suggest that save for black cohosh, there is little or no evidence to support the utility or effectiveness of herbal medicines for  relief of menopausal symptoms.  Claiming that the “efficacy and safety of such products is under researched and information on potentially-significant herb-drug interactions is limited,” the author urges healthcare professionals to routinely ask their female patients if they are using such preparations.

A few bones to pick:

1) The author has reviewed only 8 trials on black cohosh, one meta-analysis of 30 trials on red clover, 1 trial of don quai, 1 trial in evening primrose, and 1 trial of ginseng. Yet, ten minutes on Pub Med revealed over 700 published trials.

2)The author has provided no indication of which database(s) s/he searched, which begs the question, is the identification of well-designed trials with ample numbers of participants been thoroughly conducted? What’s more, definitions of  “well-designed” or “ample numbers” are not addressed within the entire review, leading one to believe that this assessment is subjective.

Give me a well-designed, well-defined review of the evidence and let’s talk. Think about the following and let’s have an intelligent dialogue. And in the interim, check out the topics in this blog. I think that you’ll find plenty of evidence to support the utility and safety of alternative therapies to address menopausal symptoms.

It’s all in the spin, isn’t it?

What do you think?

One-stop shopping

Posted by Liz on Dec 29, 2008 in herbal medicine | 4 comments

I recently ran across a press release for Menersa™, Vitaloix Labs’ neutraceutical that the company says addresses 34 common symptoms of menopause, including:

• weight gain
• hot flashes
• night sweats
• mood swings
• vaginal dryness
• urinary changes
• loss of sex drive

Wow! One pill that does ALL THAT. Company spokesperson Janice Greenberg, also says that “evidence suggests that it (Menersa™) is comparable to low-dose estradiol for relieving hot flashes.”

So, what is in this wonder “drug” anyhow?

According to the product website, Menersa™ is a combination of phytoestrogens, black cohosh, soy isoflavones and other natural ingredients.

I want to believe

Truly, I do. But if anything, science and medicine has proven that one size rarely fits all.  What’s more, the company cites clinical studies that back their efficacy claims and yet the only thing on the web is a one-pager on the supplement that contains a description, testimonials and an order form.

As regular readers of this blog knows, I am a huge fan of herbal and alternative approaches to addressing menopausal symptoms. However, I am also a stickler for data that supports any claims.

So, Vitaloix. Show me the data. And if it does what it says it does, I’ll be an enduring fan.

Any of you try Menersa™ yet? Tell me about the product.

Awake again…naturally

Posted by Liz on Dec 5, 2008 in sleep disturbance | 4 comments

[Pablo Picasso, Sleeping Woman]

When was the last time you slept through the night? Depending who you are, the stage of menopause you’re in and well, your symptoms, the answer to that question can vary. Add stress to the mix and it adds up to a lot of lost zzzs for some of us.

Experts continue to be challenged by the “s” word when it comes to the transition, with numerous recommendations ranging from yoga to hormone therapy to black cohosh to exercise to deep breathing. But again, whether or not these steps work depends on you.

I decided to delve a bit deeper into this issue and what I’m finding are many studies that don’t necessarily jive with each other. One of the latest bits of research comes from Brazil and is published in the November issue of Maturitas.

In this 6-month study, researchers examined two postmenopausal women with insomnia. Each woman participated in indivdiual therapy programs involving 1.5 hours/biweekly sessions comprising stretching, strengthening, massage and relaxation.

One woman experienced significant increases in REM and total time spent asleep, while the other had a reduction in the time it took to fall asleep and enter the initial stages of sleep (non-REM).

Both woman reported overall improvements in their insomnia.

Now mind you, I know a few women who have suffered insomnia most of their adult lives. So, I’m not certain whether or not exercise and/or relaxation truly improves overall sleep patterns when hormones and symptoms are wreaking havoc.  At the same time, however, I continue to see studies extolling the benefits of exercise and relaxation on sleep patterns, with very few reporting negative findings.

I’d love to hear your thoughts and what works or doesn’t work for you.

Trifecta

Posted by Liz on Sep 29, 2008 in weight gain | 2 comments

Midsection weight gain is a hard pill to swallow, especially when you’re doing all the things that experts keep telling you to do, like watching your diet, exercising and limiting indulgences. In fact, it’s been reported that women in their midlife years gain as much as 1.1 pounds yearly over a five-year period, which places the odds of gaining weight about twice the average rate.  So what gives?

Last week, I wrote a post on the importance of moving your body. Several experts chimed in and added that regular weight training and a change in how and what you eat might help to stave off those pounds. In the particular report cited above, researchers wrote that the one pound a year weight gain equated with only an extra 10 calories a day and suggested that small, sustained changes in daily physical activity and diet can prevent further weight gain. Okay, that sounds reasonable, right?

Another study, published last year in the Journal of Clinical Endocrinology & Metabolism, showed that weight gain and changes in waist circumference in midlife are associated with both regular aging and  changes in ovarian function.  The good news in this study was that while waist circumference increased over a 6-year period, the rate of increase slowed one year after the final menstrual period.

BTW, the reason for the buildup of fatty of tissue has to do with balance. That is, as estrogen production declines, the body starts to rely on secondary production sites, such as body fat and skin. So, fatty tissue starts function like an endocrine organ instead of simply a passive vessel for energy storage. The body also struggles to hold onto bone mass and may compensate for its loss by holding on to extra body fat longer.

The news isn’t all bad however.

That ‘Old Black Magic’ has struck again!

Results of an animal study in the journal Maturitas show that black cohosh extract attenuates body weight gain and accumulation of intrabdominal fat and also lowers glucose levels to the same extent as estrogen. The effect on blood fats in this study was a bit more complex; black cohosh extract was associated with higher LDL-cholesterol levels and lower triglyceride levels and estrogen, the exact opposite. The researchers remain uncertain how these effects ultimately influence weight gain as well as associated health risks, such as the metabolic syndrome.

These study results undoubtedly need to be replicated in humans. But they do suggest a potentially viable strategy to battle weight gain: black cohosh.

So, perhaps the trifecta in overcoming menopausal weight gain is diet, exercise and black cohosh. Only time will tell.

The Great Pretender

Posted by Liz on Sep 20, 2008 in herbal medicine | 2 comments

[youtube=http://www.youtube.com/watch?v=8o8VVczCOkI&feature=related]

Back in June, I wrote a post about the dangers of buying herbs for menopause right off the shelves.  Consumerlabs.com is now reporting that testing shows great variation in the amount and quality of herbal menopausal products., including supplements containing black cohosh, soy isoflavones, red clover isoflavones and also, progesterone creams.

For example:

• One supplement contained only 30% isoflavones despite a guarantee and another, only 65% of a specific type.
• Two products failed to comply with FDA labeling that require detailed information on plant parts used as ingredients.
• Lead contamination was found in one product.

On a more positive note, ConsumerLab found that seven soy isoflavone products met their quality standards and provided at least 50 mg to 70 mg total soy isoflavones, which is the amount research has associated with relieving hot flashes.  Additionally,

• Two red clover isoflavone products contained the correct amount (40 mg) associated with hot flash reduction.
• Six black cohosh products met quality standards.
• The progesterone creams tests provided the listed amount of progesterone, which ranged from 15 to 21 mg per gm.

You can read more about the tests at the company website.

So, what’s the take-away message from this research?

As Ellen Stern mentioned during our interview a few months ago, it’s critical to look for standardized herbs, meaning that they have undergone rigorous manufacturing practice and protocols to insure quality. She also recommended that search for “standardized x extract” on the American Botanical Council website. Finally a simple rule of thumb is that the least expensive product is not always going to be the best choice.